Commentary on pro-family issues in the media, politics and in the public square.

Monday, August 4, 2008

India says "take a hike" to UN AIDS establishment

The second largest country in the world, India decided to adopt one of the only programs which has successfully reduced the AIDS infection rate, The Ugandan ABC program which focuses on abstinence and fidelity in marriage. What's interesting is India's decision is a major rebuke to the UN AIDS establishment which pressured Uganda to drop the program, despite a major drop in HIV infection rates, in favor of the condoms approach.

A spokesperson for India's National Council of Educational Research and Training (NCERT) told the media yesterday that sex-education taught to students will focus on abstinence and fidelity, not condoms and 'safer sex.'

This announcement came after a meeting involving officials from NCERT and the National AIDS Control Organization (NACO), who, under the guidance of director-general SujathaRao, have advocated fighting AIDS with values, not condoms.

"There will be no mention of condom or safe sex in the revised module on life-skill education program. But we will be focusing on the aspirations of the youngsters and will also talk about being faithful to one's partner and abstinence. There should be no hypocrisy on the subject," said Rao, as reported by the Indian press.

"The youngsters need to get the right information. The children are growing in an unsafe environment," she added.

Originally a module was created to introduce sex-education into Indian schools to fight the spread of AIDS that promoted condoms and 'safer sex' techniques. The module, however, which included a flipchart with graphic illustrations of the human anatomy, was met with a nationwide uproar that led to seven states and many educationalists rejecting it.

The module was formulated under the direction of the UN Children's Fund (UNICEF), which is known for dumping condoms into developing nations as a means of fighting AIDS, despite hard data that shows no country has ever significantly reduced their AIDS rate using this method.

I think this is a sign of sanity in response to the tragic AIDS/HIV epidemic. Some think India's decision will embolden other countries to endorse what works - abstinence outside of marriage, fidelity within. And hopefully, this will give impetus in the United States and Minnesota to develop a morally and educationally sound approach to the AIDS epidemic. The answer is promoting healthy behavior not merely trying to mitigate the dangerous consequences of bad behavior.

2 comments:

64% of aids victimes are in africa. The passing of mother to child, to next and to next.

birth control period is the only way to heal this epidemic. To protect the next generation.

you have it wrong. Morilty does not perform disease, stupity does.

Have you not seen the numbers of HPV? The straight woman virus? even ones that have never have had sex a day before in their lives are contracting this, because of the double standard in the world of men having sex, and men allowing to have sex without a condom.

Wake up and figure out that safe educational lives are the only way to a safe and healthy life. One that would be moral and structually sound as well.

When condoms are used reliably, they have been shown to preventpregnancy up to 98 percent of the time among couples using them astheir only method of contraception. Similarly, numerous studies amongsexually active people have demonstrated that a properly used latexcondom provides a high degree of protection against a variety ofsexually transmitted diseases, including HIV infection.

Condoms are classified as medical devices and are regulated by theFood and Drug Administration. Each latex condom manufactured in theUnited States is tested for defects, including holes, before it ispackaged, and several studies clearly show that condom breakage ratesin this country are less than 2 percent. Even when condoms do break,one study showed that more than half of such breaks occurred prior toejaculation.

Although refraining from intercourse with infected partners remainsthe most effective strategy for preventing human immunodeficiencyvirus (HIV) infection and other sexually transmitted diseases (STDs),the Public Health Service also has recommended condom use as part ofits strategy. Since CDC summarized the effectiveness of condom use inpreventing HIV infection and other STDs in 1988 (1), additionalinformation has become available, and the Food and Drug Administrationhas approved a polyurethane "female condom." This report updateslaboratory and epidemiologic information regarding the effectivenessof condoms in preventing HIV infection and other STDs and the role ofspermicides used adjunctively with condoms.*

Two reviews summarizing the use of latex condoms among serodiscordantheterosexual couples (i.e., in which one partner is HIV positive andthe other HIV negative) indicated that using latex condomssubstantially reduces the risk for HIV transmission (2,3). Inaddition, two subsequent studies of serodiscordant couples confirmedthis finding and emphasized the importance of consistent (i.e., use ofa condom with each act of intercourse) and correct condom use(4,5). In one study of serodiscordant couples, none of 123 partnerswho used condoms consistently seroconverted; in comparison, 12 (10%)of 122 seronegative partners who used condoms inconsistently becameinfected (4). In another study of serodiscordant couples (withseronegative female partners of HIV-infected men), three (2%) of 171consistent condom users seroconverted, compared with eight (15%) of 55inconsistent condom users. When person-years at risk were considered,the rate for HIV transmission among couples reporting consistentcondom use was 1.1 per 100 person-years of observation, compared with9.7 among inconsistent users (5). Condom use reduces the risk forgonorrhea, herpes simplex virus (HSV) infection, genital ulcers, andpelvic inflammatory disease (2). In addition, intact latex condomsprovide a continuous mechanical barrier to HIV, HSV, hepatitis B virus(HBV), Chlamydia trachomatis, and Neisseria gonorrhoeae (2). A recentlaboratory study (6) indicated that latex condoms are an effectivemechanical barrier to fluid containing HIV-sized particles. Threeprospective studies in developed countries indicated that condoms areunlikely to break or slip during proper use. Reported breakage ratesin the studies were 2% or less for vaginal or anal intercourse(2). One study reported complete slippage off the penis duringintercourse for one (0.4%) of 237 condoms and complete slippage offthe penis during withdrawal for one (0.4%) of 237 condoms(7). Laboratory studies indicate that the female condom (Reality(trademark) **) -- a lubricated polyurethane sheath with a ring oneach end that is inserted into the vagina -- is an effectivemechanical barrier to viruses, including HIV. No clinical studies havebeen completed to define protection from HIV infection or otherSTDs. However, an evaluation of the female condom's effectiveness inpregnancy prevention was conducted during a 6-month period for 147women in the United States. The estimated 12-month failure rate forpregnancy prevention among the 147 women was 26%. Of the 86 women whoused this condom consistently and correctly, the estimated 12-monthfailure rate was 11%. Laboratory studies indicate that nonoxynol-9, anonionic surfactant used as a spermicide, inactivates HIV and othersexually transmitted pathogens. In a cohort study among women, vaginaluse of nonoxynol-9 without condoms reduced risk for gonorrhea by 89%;in another cohort study among women, vaginal use of nonoxynol-9without condoms reduced risk for gonorrhea by 24% and chlamydialinfection by 22% (2). No reports indicate that nonoxynol-9 used alonewithout condoms is effective for preventing sexual transmission ofHIV. Furthermore, one randomized controlled trial among prostitutes inKenya found no protection against HIV infection with use of a vaginalsponge containing a high dose of nonoxynol-9 (2). No studies haveshown that nonoxynol-9 used with a condom increases the protectionprovided by condom use alone against HIV infection.

Reported by: Food and Drug Administration. Center for PopulationResearch, National Institute of Child Health and Human Development,National Institutes of Health. Office of the Associate Director forHIV/AIDS; Div of Reproductive Health, National Center for ChronicDisease Prevention and Health Promotion; Div of Sexually TransmittedDiseases and HIV Prevention, National Center for Prevention Svcs; Divof HIV/AIDS, National Center for Infectious Diseases, CDC.

Editorial Note: This report indicates that latex condoms are highlyeffective for preventing HIV infection and other STDs when usedconsistently and correctly. Condom availability is essential inassuring consistent use. Men and women relying on condoms forprevention of HIV infection or other STDs should carry condoms or havethem readily available.

Correct use of a latex condom requires 1) using a new condom with eachact of intercourse; 2) carefully handling the condom to avoid damagingit with fingernails, teeth, or other sharp objects; 3) putting on thecondom after the penis is erect and before any genital contact withthe partner; 4) ensuring no air is trapped in the tip of the condom;5) ensuring adequate lubrication during intercourse, possiblyrequiring use of exogenous lubricants; 6) using only water-basedlubricants (e.g., K-Y jelly (trademark) or glycerine) with latexcondoms (oil-based lubricants (e.g., petroleum jelly, shortening,mineral oil, massage oils, body lotions, or cooking oil) that canweaken latex should never be used); and 7) holding the condom firmlyagainst the base of the penis during withdrawal and withdrawing whilethe penis is still erect to prevent slippage.

Condoms should be stored in a cool, dry place out of direct sunlightand should not be used after the expiration date. Condoms in damagedpackages or condoms that show obvious signs of deterioration (e.g.,brittleness, stickiness, or discoloration) should not be usedregardless of their expiration date.

Natural-membrane condoms may not offer the same level of protectionagainst sexually transmitted viruses as latex condoms. Unlike latex,natural- membrane condoms have naturally occurring pores that aresmall enough to prevent passage of sperm but large enough to allowpassage of viruses in laboratory studies (2).

The effectiveness of spermicides in preventing HIV transmission isunknown. Spermicides used in the vagina may offer some protectionagainst cervical gonorrhea and chlamydia. No data exist to indicatethat condoms lubricated with spermicides are more effective than otherlubricated condoms in protecting against the transmission of HIVinfection and other STDs. Therefore, latex condoms with or withoutspermicides are recommended.

The most effective way to prevent sexual transmission of HIV infectionand other STDs is to avoid sexual intercourse with an infectedpartner. If a person chooses to have sexual intercourse with a partnerwhose infection status is unknown or who is infected with HIV or otherSTDs, men should use a new latex condom with each act ofintercourse. When a male condom cannot be used, couples shouldconsider using a female condom.

Data from the 1988 National Survey of Family Growth underscore theimportance of consistent and correct use of contraceptive methods inpregnancy prevention (8). For example, the typical failure rate duringthe first year of use was 8% for oral contraceptives, 15% for malecondoms, and 26% for periodic abstinence. In comparison, persons whoalways abstain will have a zero failure rate, women who always useoral contraceptives will have a near-zero (0.1%) failure rate, andconsistent male condom users will have a 2% failure rate (9). Forprevention of HIV infection and STDs, as with pregnancy prevention,consistent and correct use is crucial.

The determinants of proper condom use are complex and incompletelyunderstood. Better understanding of both individual and societalfactors will contribute to prevention efforts that support persons inreducing their risks for infection. Prevention messages must highlightthe importance of consistent and correct condom use (10).